The Care, Support and Treatment needs of HIV positive people vary with the stage of the infection.

The HIV (virus) can kill many different types of cells in the body, but the primary targets are cells called CD4 T-cells, which are a kind of white blood cells that helps the body’s immune system respond to diseases. Once immune cells die, the body cannot fight diseases. WHO recommends ART treatment if the CD4 count in blood falls below 350 cells/mm3 of blood. 
The medicines are supposed to be patient-friendly. WHO now recommends that HIV-positive mothers and their infants take ARVs while breastfeeding, to prevent HIV transmission to the new born.

India uses two-drug and three–drug combinations under its ART programme. Medicines like Stavudine, Lamivudine, Nevirapine, Efavirenz and Zidavudin are given in combination to increase resistance among HIV positive patients. At present seven Indian companies make generic first–line ART drugs.  

An HIV-infected person remains asymptomatic (does not show any symptoms of the illness though he/she may be infected) for the few initial years of the infection. The symptoms of HIV /AIDS illness start showing only by the sixth to the eighth year of infection.

As immunity falls over time, the infected person becomes susceptible to various opportunistic infections (OIs) also, such as tuberculosis, pneumonia etc. At this stage, medical treatment and psycho-social support is absolutely essential. Access to prompt diagnosis and treatment of OIs ensures that people living with HIV/AIDS (PLHAs) live longer and have a better quality of life.

Under the National AIDS Control Programme-II, focus was on low-cost care, support and treatment of common OIs.

Anti-Retroviral Treatment:  In India, 2.3 m people live with HIV. About 300,000  are on ART (NACO data for Nov 2009), NACO provides free ART at a cost of about Rs 100 crore across the country since 2004. 

IN TAMIL NADU:To achieve the above objective in Tamil Nadu, 37 ART centres have been started in   all the district medical colleges and district head quarters. In addition, 90 Link ART centres have been established at sub-district level  to increase accessibility and enhance adhere to ART. As many as 140,000 PLHAs have been registered. Among these, 40,000 PLHAs are taking free ARV medicines at these Tamil Nadu centres.

CCC: Community care centres: For counselling for individual and family, monitoring drug adherence, Nutrition support, Linkage with other services.
 As many as 40 Community Care Centres (CCC) have been started in partnership with NGOs/PLHAs  in high-prevalence and moderate-prevalence districts.

These centres are being established,  based on the epidemiological profile and PLHA load in a particular district. Each district CCC is linked to the nearest ART centre.  The centres  provide counselling for drug adherence, nutritional needs, treatment support, referral and outreach for follow up, social support and legal services.

State AIDS Prevention and Control Societies (SACS) ensure that  high-risk groups access  the community care centres through linkages between targeted interventions (TIs)  and the centres.

Approximately 50,000 children below 15 years are infected by HIV every year. So far, care and support response to these children was at a very minimal level. NACP – III plans to improve this through early diagnosis and treatment of HIV-exposed children.

The programme now provides comprehensive guidelines on paediatric HIV care for each level of the national health system; special training to counsellors for counselling HIV positive children; linkages with social sector programmes for accessing social support for infected children; outreach and transportation subsidy to facilitate ART and follow up; nutritional, educational, recreational and skill development support.

In Tamil Nadu, the programme now promotes establishing and enforcing minimum standards of care and institutional protection, foster care and community- based care systems.